NHS increases efforts to recruit doctors from overseas

Abstract

Schemes to recruit doctors from overseas are being launched in a bid to help the UK tackle some of the workforce problems it faces in both primary and secondary care. Abi Rimmer explores how some of these schemes are working out

When the General Practice Forward View was published in April last year, it announced plans for a “major new international recruitment campaign to attract up to an extra 500 appropriately trained and qualified doctors from overseas.”1 Following this announcement, NHS England launched the International GP Recruitment Programme.

The programme will be delivered in two phases.1 Phase one began in 2016 and focuses on a number of high priority areas in England. Funding for the second phase of the programme will be agreed this month, with the pilots launching in April.

Lincolnshire was the first phase one pilot area to be announced. Further sites would start recruitment later this month, and a spokesman for NHS England said that details of these sites would be released “in the next few weeks.”

Lincolnshire’s scheme, which aims to recruit GPs from across Europe to fill vacancies in the county, predates the NHS England programme and was adopted as its scoping pilot. Initially set up by Lincolnshire Local Medical Committee (LMC), it recruited 12 GPs in its first phase. The second phase of recruitment began in January.

Workforce challenges

Kieran Sharrock, medical director of Lincolnshire LMC, says that the scheme was launched around 18 months ago because of a diminishing GP workforce in the area. “More and more GPs are retiring early. We know that in Lincolnshire we have around 75 GPs who are due to retire in the next five years,” he says. “Over the past five years we’ve had a similar number of retirees. People are leaving the profession earlier because of the increasing workload.”

To help shore up the diminishing GP workforce, the LMC decided to look to Europe as a source of recruitment. “We had a number of GPs who trained in Europe or who had contacts there in medical schools or GP training schemes,” Sharrock says. “So we contacted them and there was quite a lot of interest.”

Recruitment to the scheme began in September, and a recruitment company was used to identify doctors from across 16 countries who wanted to come to the UK. Sharrock says that the recruitment firm screened candidates for their suitability to life as a GP in Lincolnshire. The LMC then decided who they wanted to interview and interviews were held in November and December.

“The GP practices who were recruiting through the scheme interviewed the candidates, we met with the candidates, and NHS England met with the candidates. We then agreed who was going to be coming,” Sharrock says. “The practices made job offers and the candidates then either accepted or rejected them.”

Candidates

Sharrock says that the successful candidates are now in Poland where they will spend three months “doing language training, being given some training in NHS processes, and also being given some training in English culture so that when they come here it’s not too much of a shock.”

The 12 successful candidates who have been recruited through the scheme have been offered three year salaried GP contracts with the condition that they will work in the recruiting practice for the three years. They are expected to start working from the end of April.

In addition to the 12 initial recruits, Sharrock says that the LMC was carrying out interviews with 20 more doctors in February. “By the end of the process we will have recruited 25 GPs to approximately 20 practices,” he says.

Even if the scheme is a success, Sharrock says that it will not solve Lincolnshire’s GP recruitment problem. “This isn’t going to solve the problem. We’re still going to be significantly short of GPs and other clinicians,” he says. “I would love to be able to continue doing this but it’s a matter of funding.”

Currently, funding for the scheme has come from a number of sources, Sharrock says, including NHS England and Health Education England (HEE), as well as the LMC itself. Sharrock says that it’s unlikely that it can expect continued funding at the same level. “We’re very fortunate to be identified as a pilot site and hopefully NHS England will continue to fund it, but the likelihood is that they will fund other areas first.”

Other specialties

It’s not just the GP workforce that will be boosted by doctors from overseas.

In Scotland, the Royal College of Radiologists has recently called on the Scottish government to recruit doctors from overseas to fill consultant radiologist posts. In order to help assimilation into the NHS, the college has produced series of resources for doctors and their new radiology departments.2

Also, in 2014, HEE began an emergency medicine development programme. The programme aimed to recruit doctors from India. That year, 67 appointable doctors were selected, although two chose not to take up a place on the scheme.3

HEE hoped to recruit at least 50 doctors to the four year programme, into core training years 2 and 3, and specialty training year 4. It said that the College of Emergency Medicine exams were “formally adopted” in India and that emergency medicine competences in India therefore aligned with those in the UK.4

Applicants who were successful in a Skype interview had face to face interviews in India in May of 2014 and successful applicants then took up their posts in England in August that year.

A separate scheme to employ emergency medicine doctors from India and Pakistan has also been launched by Wrightington, Wigan and Leigh Foundation Trust.5 The scheme will start in Greater Manchester, with 20 medics due to be flown from India this year for up to three years.

Andrew Foster, chief executive of Wrightington, Wigan and Leigh NHS Foundation Trust, says that the scheme was an expansion of one that the trust had run for a number of years for trauma and orthopaedics doctors. That scheme, Foster said, brings in at least 40 doctors a year to work in orthopaedics.

The new scheme will focus on emergency medicine. It aims to recruit around 20 doctors in its first phase who will work in trusts across Greater Manchester. “This is a scheme that we are piloting with Health Education England in Greater Manchester but the intention is to expand to all parts of the country very quickly afterwards,” Foster says.

He adds, “Emergency medicine is the biggest and most important workforce shortage that we have, not just in Greater Manchester but elsewhere too.”

Career progression

Under the scheme the doctors—who will have an undergraduate medical degree and have worked for around three years—will be recruited to work in the UK for two to three years. During that time they will work as middle grade doctors in emergency departments and train for a formal qualification in emergency medicine. Once the scheme has ended, the majority of the doctors are expected to return to India.

The scheme, Foster says, is mutually beneficial. “At the moment there isn’t really a specialty of emergency medicine in India but they are trying to set one up. Part of the training course would be working in busy emergency medicine departments,” he says.

“So India needs to find somewhere for trainees to gain experience, and England needs doctors that can work in busy emergency departments. So they are perfectly well matched if you can make it happen and that is exactly what we are trying to do.”

Brexit boost

There have been concerns that the UK’s decision to leave the European Union would hamper recruitment to the NHS from overseas. But Kieran Sharrock, medical director of Lincolnshire LMC, says that has not been their experience, and that there was no difficulty in recruiting doctors to the scheme.

“We’ve actually experienced a surge in interest since the Brexit vote,” he says. “The feedback that we’re getting from the people we have recruited is that they had been thinking about coming to the UK for some time but hadn’t done anything about it. And then when we voted to leave they thought, ‘Actually we need to get to the UK before they trigger article 50 within the next two or three years.’ So it may have even benefited us.”